Euthanasia

Euthanasia

Context

The Supreme Court of India reserved its judgment in the case of Harish Rana, a 31-year-old man in a Permanent Vegetative State (PVS) for over 13 years after a fall. The Bench led by Justice J.B. Pardiwala and Justice K.V. Viswanathan personally interacted with the family to understand their long struggle and the economic burden of clinically assisted nutrition, making it a crucial moment in India’s end-of-life jurisprudence.

Understanding Euthanasia

Euthanasia comes from Greek: eu (“good”) + thanatos (“death”). It is classified as:

1. Active Euthanasia
    
   • Direct act to end life (e.g., lethal injection)
      
   • Illegal in India (treated as homicide)
      
2. Passive Euthanasia
    
   • Withdrawal/withholding of life support (ventilator, feeding support, etc.)
      
   • Legal in India under strict safeguards
      
3. Assisted Suicide
    
   • Providing means for a person to end life (e.g., prescription drugs)
      
   • Illegal in India under Section 306 IPC (Abetment of Suicide)
      

Legal Framework in India

India does not have a dedicated euthanasia law; the framework is based mainly on Supreme Court judgments:

• Aruna Shanbaug Case (2011)
   
  • First recognition of passive euthanasia for PVS patients
     
• Common Cause v. Union of India (2018)
   
  • SC held Right to Die with Dignity is part of Article 21 (Right to Life)
     
  • Recognised legality of Living Wills (Advance Medical Directives)
     
• 2023 Guidelines Modification (Living Will Procedure Simplified)
   
  • Removed need for Judicial Magistrate countersignature
     
  • Empowered Medical Boards to take final decisions under safeguards
     

Two-Tier Safeguard System (For Passive Euthanasia)

Ethical and Economic Dimensions

1. Futile Treatment Debate
 In the Harish Rana case, the SC observed that continuing mechanical life support with no recovery possibility may itself violate human dignity.

2. Economic Distress (Healthcare Cost Burden)
 The family argued that 13 years of care exhausted savings. In India, high Out-of-Pocket Expenditure (OOPE) often makes long-term vegetative care financially impossible for middle-class families.

3. Autonomy vs Sanctity of Life

• Supporters: Emphasise patient autonomy and dignity-based choice
   
• Opponents: Stress sanctity of life, warning of a “slippery slope” where vulnerable elderly/disabled persons may face pressure
   

Global Status (Comparison)

• Active Euthanasia allowed:
   Netherlands, Belgium, Luxembourg, Spain, Canada
   
• Assisted suicide allowed:
   Switzerland (legal since 1942), and some US states (e.g., Oregon)
   
• India’s Middle Path:
   Allows Passive Euthanasia under safeguards but rejects Active Euthanasia and Assisted Suicide, aiming to balance dignity with misuse prevention.
   

Conclusion

The Harish Rana case (2026) is the first major judicial test after the 2023 simplified guidelines. It compels the Court to clarify whether feeding tubes/clinically assisted nutrition qualify as life-sustaining treatment that can be withdrawn under passive euthanasia. The judgment is likely to shape how India balances constitutional dignity (Article 21), medical ethics, family suffering, and the economics of long-term care.